Annals for Hospitalists Inpatient Notes - Clinical Pearls—Outpatient Parenteral Antimicrobial Therapy for Infective Endocarditis in Persons Who Inject Drugs
Authors: Larry M. Baddour, Daniel C. DeSimone
Journal: Annals of Internal Medicine (2023)

Web ExclusivesMarch 2023Annals for Hospitalists Inpatient Notes - Clinical Pearls—Outpatient Parenteral Antimicrobial Therapy for Infective Endocarditis in Persons Who Inject DrugsLarry M. Baddour, MD and Daniel C. DeSimone, MDLarry M. Baddour, MDDivision of Public Health, Infectious Diseases and Occupational Health, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic Rochester, Rochester, Minnesota (L.M.B., D.C.D.).Search for more papers by this author and Daniel C. DeSimone, MDDivision of Public Health, Infectious Diseases and Occupational Health, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic Rochester, Rochester, Minnesota (L.M.B., D.C.D.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0241 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A 26-year-old woman presented to the emergency department for fever and chills of 5 days duration. Her recent history included injection drug use of both heroin and cocaine, and she had shared paraphernalia on 2 occasions over a weekend party. She was ultimately diagnosed with bilateral (tricuspid and aortic) infective endocarditis (IE) due to methicillin-susceptible Staphylococcus aureus. After an 8-day hospital stay, she was transitioned to outpatient parenteral antimicrobial therapy (OPAT) and buprenorphine (which had been initiated on day 2 of the hospital stay), with outpatient follow-up by addiction medicine and infectious diseases. A peripherally inserted central catheter (PICC) was ...References1. Baddour LM, Weimer MB, Wurcel AG, et al; American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Peripheral Vascular Disease. Management of infective endocarditis in people who inject drugs: a scientific statement from the American Heart Association. Circulation. 2022;146:e187-201. [PMID: 36043414] doi:10.1161/CIR.0000000000001090 CrossrefMedlineGoogle Scholar2. Morales Y, Smyth E, Zubiago J, et al. “They just assume that we're all going to do the wrong thing with it. It's just not true”: stakeholder perspectives about peripherally inserted central catheters in people who inject drugs. Open Forum Infect Dis. 2022;9:ofac364. doi:10.1093/ofid/ofac364 CrossrefGoogle Scholar3. Eaton EF, Mathews RE, Lane PS, et al. A 9-point risk assessment for patients who inject drugs and require intravenous antibiotics: focusing inpatient resources on patients at greatest risk of ongoing drug use. Clin Infect Dis. 2019;68:1041-3. [PMID: 30165395] doi:10.1093/cid/ciy722 CrossrefMedlineGoogle Scholar4. Iversen K, Ihlemann N, Gill SU, et al. Partial oral versus intravenous antibiotic treatment of endocarditis. N Engl J Med. 2019;380:415-24. [PMID: 30152252] doi:10.1056/NEJMoa1808312 CrossrefMedlineGoogle Scholar5. Wildenthal JA, Atkinson A, Lewis S, et al. Outcomes of partial oral antibiotic treatment for complicated S. aureus bacteremia in people who inject drugs. Clin Infect Dis. 2022. [PMID: 36052413] doi:10.1093/cid/ciac714 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Larry M. Baddour, MD; Daniel C. DeSimone, MDAffiliations: Division of Public Health, Infectious Diseases and Occupational Health, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic Rochester, Rochester, Minnesota (L.M.B., D.C.D.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0241.Corresponding Author: Larry M. Baddour, MD, Division of Public Health, Infectious Diseases and Occupational Health, 200 First Street SW, Rochester, MN 55905; e-mail, baddour.[email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - March 2023 David H. Wesorick Metrics March 2023Volume 176, Issue 3KeywordsEndocarditisHospital medicineOpioid use disorder ePublished: 21 March 2023 Issue Published: March 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...